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Is your child/client constantly skipping words while reading, losing their place on the page, or avoiding reading altogether? These might not be “reading problems”—they could be visual problems.
In this episode, we break down howocular motor skills—specifically saccades, pursuits, and convergence—are essential for reading success. You’ll learn how these visual skills impact everything from decoding to attention span, and why children with ADHD, sensory processing disorder, or retained primitive reflexes are at higher risk for visual-motor challenges.
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https://pmc.ncbi.nlm.nih.gov/articles/PMC11698614/
https://jov.arvojournals.org/article.aspx?articleid=2792416
If your child is struggling with reading—avoiding books, skipping words, or melting down during homework—it might look like ADHD. But what if the root cause isn’t attention at all?
We once interviewed a mother whose son was about to be diagnosed with ADHD due to inattention and distractibility, especially during reading and writing tasks. After a functional vision evaluation, they discovered the real issue: his eyes weren’t working together.
Once he completed a vision therapy program, his ADHD-like symptoms disappeared. In many cases, challenges with reading and focus stem from ocular motor dysfunction—how the eyes move and work together—not from attention deficits.
Ocular motor skills are the eye movement abilities that help us visually navigate the world. They’re foundational for everything from copying off the board to reading fluently.
Saccades
Quick jumps between two points (like moving from one word to the next or between lines of text).
Pursuits
Smooth tracking of a moving object (like following a word across a line while reading).
Convergence & Divergence
Eyes moving inward (convergence) or outward (divergence) to maintain focus on a near or far object—essential for reading a book or copying from the board.
Even if your child passes a 20/20 vision screening, they may still struggle with how their eyes work together to process visual information.
Skipping lines or words while reading.
Needing to use a finger to track text (beyond early learning years).
Complaints of blurry vision or headaches.
Avoidance of reading or writing tasks.
Moving their entire head rather than just their eyes.
Poor comprehension and slow reading speed.
These signs often mimic ADHD—but the underlying issue may be related to visual tracking and coordination, not attention.
Primitive reflexes are automatic movements all babies are born with. They support early survival but should fade (or “integrate”) within the first year of life.
When these reflexes persist, they can interfere with motor coordination, attention, and—yes—ocular motor development.
ATNR (Asymmetrical Tonic Neck Reflex):Impairs cross-midline eye movement, making it hard to track smoothly across a page.
STNR (Symmetrical Tonic Neck Reflex):Disrupts the ability to switch focus between near and far (like board to paper), making copying tasks difficult.
TLR (Tonic Labyrinthine Reflex):Affects posture and head control, which are key for steady eye movement.
Moro Reflex:Linked to visual hypersensitivity and general sensory overwhelm.
Watch for these common behaviors:
Avoiding reading or writing.
Losing their place frequently.
Skipping words or lines.
Needing to use a finger to track.
Head movements instead of eye movements.
Complaints of eye strain or headaches.
Dislike of sports requiring hand-eye coordination.
Slow or sloppy handwriting.
If your child is demonstrating several of these signs, it’s worth exploring further.
Visit a developmental or neuro-optometrist, not just a traditional optician. They’ll assess how the eyes function as a team, not just visual acuity.
You can ask your pediatrician or occupational therapist for a referral.
If your child isn’t already working with an OT, it can be incredibly beneficial—especially one trained in:
Visual motor integration.
Sensory processing.
Primitive reflex integration.
These exercises are fun, low-pressure, and can be done with minimal equipment.
Turn off the lights and shine a flashlight across the wall. Have your child track the light using just their eyes—not their head.
Stick flashcards or alphabet letters around a room. Ask your child to find letters in a certain order using a laser pointer or ball toss.
Draw a large sideways 8 on a wall or paper. Have your child trace it with a finger, marker, or flashlight while keeping their head still.
Give prompts like: “Look at the window without moving your head.” Great for teaching dissociation of head and eye movement.
Hold a pencil at arm’s length and slowly bring it toward the nose. Have your child follow with both eyes until they see double. Then move it back. Repeat 3–5 times.
Incorporate:
Cat-cow stretches.
Crawling forward and backward.
Superman and banana holds.
Pair these with visual tasks like reading a chart or identifying letters on the wall for added benefit.
We’ve seen this firsthand. One mom’s son was labeled as inattentive, unfocused, and showing ADHD symptoms—until a vision therapy evaluation changed everything.
After just a few months of targeted ocular motor and convergence training, his symptoms resolved. He could focus, read with ease, and actually enjoyed school again.
This doesn’t mean all ADHD diagnoses are incorrect—but itdoes mean vision should be part of the conversation.
If you’ve tried activities at home and you’re still noticing:
Strong resistance to reading.
Behavioral meltdowns during schoolwork.
Physical complaints like headaches or eye fatigue.
A formal ADHD diagnosis without a vision assessment.
Then it’s time to:
Get a referral to a developmental optometrist.
Pursue outpatient occupational therapy.
Explore primitive reflex integration strategies.
If your child avoids reading or seems inattentive, don’t jump to conclusions. Ocular motor dysfunction is often overlooked, but it can have a profound impact on learning.
Small steps lead to big changes. By taking action now—whether that’s trying a few activities or seeking professional evaluation—you’re helping your child build confidence, independence, and joy in learning.
BORING, BUT NECESSARY LEGAL DISCLAIMERS
While we make every effort to share correct information, we are still learning. We will double check all of our facts but realize that medicine is a constantly changing science and art. One doctor / therapist may have a different way of doing things from another. We are simply presenting our views and opinions on how to address common sensory challenges, health related difficulties and what we have found to be beneficial that will be as evidenced based as possible. By listening to this podcast, you agree not to use this podcast as medical advice to treat any medical condition in either yourself or your children. Consult your child’s pediatrician/ therapist for any medical issues that he or she may be having. This entire disclaimer also applies to any guests or contributors to the podcast. Under no circumstances shall Rachel Harrington, Harkla, Jessica Hill, or any guests or contributors to the podcast, as well as any employees, associates, or affiliates of Harkla, be responsible for damages arising from use of the podcast.
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This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast.
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